Provider First Line Business Practice Location Address:
FAS PSYCH, LCC
Provider Second Line Business Practice Location Address:
8687 E. VIA DE VENTURA, #310
Provider Business Practice Location Address City Name:
SCOTTSDALE
Provider Business Practice Location Address State Name:
AZ
Provider Business Practice Location Address Postal Code:
85258
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
508-559-1567
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
02/11/2014